Individual provider Active NPI

Gary L. Poling, D.O.

  • Family Medicine Physician
  • Beckley, WV
National Provider Identifier
1487730941
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
WV1221 Issued in WV
Practice address
25 Mallard CT
Beckley, WV 25801-3664
Phone
(304) 929-6020
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X WV1221 WV Primary

Addresses

Primary practice location

25 Mallard CT
Beckley, WV 25801-3664

Mailing address

25 Mallard CT
Beckley, WV 25801-3664
Phone (304) 929-6020

Other identifiers 1

IdentifierTypeStateIssuer
0053014000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040211000948 WV Practitioner - Family Practice 0648176321 Reassigns benefits to 1 organization
Practice locations: Beckley, WV

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenbrier Clinic IncGroup PAC ID 0345298915, 10 clinicians

Practice addresses (Care Compare)

40823 Midland TRL E
White Sulphur Springs, WV 24986-5064
Phone (304) 536-4870

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1221WVMDProfessional Counselor
WV1221WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Clinic Surgery Center Current Accepting new patients
Greenbrier Clinic, Inc. CurrentSince Mar 1, 2019 Accepting new patients

Locations

40823 Midland Trl E
Wht Sphr Spgs, WV 24986
Phone (304) 536-4870

Interoperability endpoints

  • Direct secure messaging: gary.poling.1@6482.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1487730941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MALLARD CT",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013664",
            "telephone_number": "304-929-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MALLARD CT",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013664",
            "telephone_number": "304-929-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "WV1221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053014000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.